A Comprehensive Nationwide Study of the Incidence Rate and Lifetime Risk for Treated Mental Disorders
A Comprehensive Nationwide Study of the Incidence Rate and Lifetime Risk for Treated Mental Disorders
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DOI：
10.1001/jamapsychiatry.2014.16
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发表时间：
2014-05-01
期刊：
影响因子：
25.8
通讯作者：
Eaton, William W.
中科院分区：
文献类型：
--
作者：
Pedersen, Carsten Bocker;Mors, Ole;Eaton, William W.
重要性了解精神障碍的生活过程的流行病学概况是研究和规划卫生保健的基础。虽然以前的研究已经使用人口调查，信息和补充估计可以从人口为基础的registers. ObjectiveTo获得全面和准确的估计发病率和终身风险的任何精神障碍和一系列特定的精神障碍。设计，设置，和参与者我们进行了一项后续研究的所有丹麦居民（560万人），所有治疗均由政府卫生保健系统免费提供，从2000年1月1日至2012年12月31日（总随访，5950万人年）。在研究期间，320 543人因任何精神障碍在精神病院接受了第一次终生治疗; 489 006人因死亡而被审查; 69 987人因移民而被审查。调查的精神障碍的具体类别包括器质性精神障碍、物质滥用障碍、精神分裂症、心境障碍、焦虑、饮食障碍、人格障碍、精神发育迟滞、广泛性发育障碍以及行为和情绪障碍。37.66%的女性（95% CI，37.52%-37.80%）和32.05%的男性（31.91%-32.19%）因任何精神障碍首次在精神科接受治疗。精神障碍的发生率在诊断类别之间以及在性别和年龄之间存在明显差异。许多精神障碍的性别和年龄特异性发病率在生命的第二个和第三个十年期间有一个单一的发病率高峰。一些疾病的第二个高峰期的性别和年龄特异性发病率在life.Conclusions和相关性这一全国性的研究提供了第一个全面的评估治疗精神疾病的终生风险。大约三分之一的丹麦人口接受精神疾病治疗。不同的精神障碍与性别和年龄的不同签名有重要的意义，服务规划和病因学研究。
IMPORTANCE Understanding the epidemiologic profile of the life course of mental disorders is fundamental for research and planning for health care. Although previous studies have used population surveys, informative and complementary estimates can be derived from population-based registers.OBJECTIVE To derive comprehensive and precise estimates of the incidence rate of and lifetime risk for any mental disorder and a range of specific mental disorders.DESIGN, SETTING, AND PARTICIPANTS We conducted a follow-up study of all Danish residents (5.6 million persons), to whom all treatment is provided by the government health care system without charge to the patient, from January 1, 2000, through December 31, 2012 (total follow-up, 59.5 million person-years). During the study period, 320 543 persons received first lifetime treatment in a psychiatric setting for any mental disorder; 489 006 persons were censored owing to death; and 69 987 persons were censored owing to emigration. Specific categories of mental disorders investigated included organic mental disorders, substance abuse disorders, schizophrenia, mood disorders, anxiety, eating disorders, personality disorders, mental retardation, pervasive developmental disorders, and behavioral and emotional disorders.EXPOSURES Age and sex.MAIN OUTCOMES AND MEASURES Sex-and age-specific incidence rates and cumulative incidences and sex-specific lifetime risks.RESULTS During the course of life, 37.66% of females (95% CI, 37.52%-37.80%) and 32.05% of males (31.91%-32.19%) received their first treatment in a psychiatric setting for any mental disorder. The occurrence of mental disorders varied markedly between diagnostic categories and by sex and age. The sex-and age-specific incidence rates for many mental disorders had a single peak incidence rate during the second and third decades of life. Some disorders had a second peak in the sex-and age-specific incidence rate later in life.CONCLUSIONS AND RELEVANCE This nationwide study provides a first comprehensive assessment of the lifetime risks for treated mental disorders. Approximately one-third of the Danish population received treatment for mental disorders. The distinct signatures of the different mental disorders with respect to sex and age have important implications for service planning and etiologic research.